A psychedelics expert says magic mushrooms will be approved for depression by 2027 — here's why

Ask a healthy person who's tripped on psychedelics what it felt
like, and they'll probably tell you they saw sounds or heard
colors: The crash-bang of a dropped box took on an aggressive,
dark shape. A bright green light seemed to emit a piercing,
high-pitched screech.

In actuality, this "cross-wiring" — synaesthesia, as it's known
scientifically — may be one example of the drug "freeing" the
brain from its typical connection patterns. And
this fundamental change in how the brain sends and receives
information also might be the reason the drugs are so promising
as a treatment for people with mental illnesses like depression,
anxiety, or addiction.

"I'm absolutely sure that, within ten years, psilocybin
will be an accepted treatment for
depression," David Nutt, the
director of the neuropsychopharmacology unit in the division of
brain sciences at Imperial College London told me last month.

To understand why he might believe this so strongly, it helps to
take a look first at how a healthy brain works — and then at how
a psychedelic trip appears to modify the way a depressed brain
does.

Normally, information is exchanged in the brain across various
circuits, or what Paul
Expert, who coauthored one of the first studies to map the
activity in the human brain on psilocybin, described to me as
"informational highways." On some highways, there's a steady
stream of traffic. On others, however, there are rarely more than
a few cars on the road. Psychedelics appear to
drive traffic to these underused highways, opening up dozens
of different routes and freeing up some space along the more
heavily used ones.

Robin
Carhart-Harris, who leads the psychedelic research arm of the
Center for Neuropsychopharmacology at Imperial College London,
captured these changes in one of the first neuroimaging studies
of the brain on a psychedelic trip. He presented his findings
last year in New York at a conference on the therapeutic
potential of psychedelics. With psilocybin, "there was a definite
sense of lubrication, of freedom, of the cogs being loosened and
firing in all sorts of unexpected directions," Carhart-Harris
said.

This might be just the kick-start that a depressed brain needs.

Here's a visualization that Expert created to show the brain
connections in a person on psilocybin (shrooms) — the chart on
the right — compared to the connections in the brain of someone
not on the drug (left):

One key characteristic of depression is
overly strengthened connections in brain circuits in certain
regions of the brain — particularly those involved in
concentration, mood, conscious thought, and the sense of self.
This may be part of the reason that electroconvulsive therapy,
which involves placing electrodes on the temples and delivering a
small electrical current, can help some severely depressed people
— it
tamps down on some of this traffic.

"In the depressed brain, in the addicted brain, in the obsessed
brain, it gets locked into a pattern of thinking or processing
that's driven by the frontal, the control center, and they cannot
un-depress themselves," Nutt told me.

Nutt is one of the pioneering researchers in the field of
studying how psychedelics might be used to treat mental illness.
He said that in depressed people, these overly trafficked
circuits — think West Los Angeles at rush hour — can lead to
persistent negative thoughts. Feelings of self-criticism can get
obsessive and overwhelming. So to free someone with depression
from those types of thoughts, traffic would need to be diverted
from some of these congested ruts and, even better, redirected to
emptier highways.

"Psychedelics disrupt that process so people can escape," Nutt
said. "At least for the duration of the trip, they can escape
about the ruminations about depression or alcohol or obsessions.
And then they do not necessarily go back."

Last year, a team of Brazilian researchers published a review of
all the clinical trials on psychedelics published between
1990 and 2015. After looking at 151 studies, the researchers
found only six that met their analysis criteria. The rest were
either too small, too poorly controlled, or problematic for
another reason.

Boxes
containing magic mushrooms sit on a counter at a coffee and smart
shop in Rotterdam November 28, 2008.

Nevertheless, based on the six studies, the researchers concluded
that
ayahuasca, psilocybin, and LSD may be "useful pharmacological
tools for the treatment of drug dependence, and anxiety and mood
disorders, especially in treatment-resistant patients."

"These drugs may also be useful pharmacological tools to
understand psychiatric disorders and to develop new therapeutic
agents," they wrote.

Because the existing research is so limited, scientists still
can't say exactly what is happening in the brain of someone who
has tripped on psychedelics.

What we do know, though, is that things like practicing a musical
instrument or learning a skill change the brain, and it's
possible that psychedelics do something similar over the long
term — even if the actual trip, the phase of drug use that many
people focus on, is pretty brief.

In other words, a trip "might trigger a sort of snowball effect"
in the way the brain processes information, said Expert.

And something about the experience appears to be much more
powerful for some people than even years of taking
antidepressants.

A
small recent trial of psilocybin in people whose chronic
depression had not responded to repeated attempts at treatment
with medication suggested that this may be the case. While the
trial, co-directed
by Amanda Feilding, who founded the Beckley Foundation, was
designed to determine only if the drug was safe, all of the study
participants said at a one-week follow-up that they saw a
significant decrease in symptoms. The majority said at a
follow-up three months later that they continued to see a
decrease in symptoms.

"We treated people who'd been suffering for 30 years, and they're
getting better with a single dose," said Nutt, who was one of the
authors of the study. "So that tells us this drug is doing
something profound."